Athletes demand more from their knees than an infant does from its mother—or at least it seems that way. Support me while I pound the pavement during a run, we ask them, or while I kick a soccer ball or pivot quickly on the tennis court or land hard after a layup.
Fortunately, most of the time, the knees agree, twisting, turning, and absorbing shock so that you can keep playing. The mere thought of them failing is enough to make any athlete, um, weak in the knees—the joint is so vital to all athletic endeavors, from aerobics to water-skiing, that when it hurts, the game is over.
While all knee injuries demand attention, the severity of the problem dictates what action to take. Obviously, a carry-me-off-the-field or I-heard-it-pop injury requires a qualified doctor to diagnose the exact condition and recommend treatment. Once the knee is back to a functional state, yoga can prevent further injury by stretching and strengthening the muscles that surround the joint and promoting correct body alignment. For common problems, like arthritis and small sprains and strains, yoga is equally beneficial.
First, a little anatomy lesson. The framework for the knee is surprisingly fragile. The joint, which connects the femur (thigh bone) and the tibia (shin bone), is a hinge which doesn’t fit perfectly together, unlike other joints like the hip, a ball-in-socket configuration, or the ankle, which slides together like two puzzle pieces. Instead of the fundamental bone-in-bone support offered in the hip and ankle, the knee relies on relatively small ligaments—the anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, and lateral collateral ligament—to connect the bones to one another and provide stability. The hamstring muscle, located at the back of the thigh, bends the knee, while the quadriceps, on the front of the thigh, straightens it. The patella (knee cap) is actually encased in the thigh muscle, so anytime your quad moves, the patella moves too.
Compounding the delicate set-up is the knee’s location, between the ankles and hips. “Any imbalance or injury incurred in either of those two joints will directly affect the knee,” says Peggy Wallin, a former dancer who has taught yoga for four years at The Energy Center in Brooklyn, New York.
Actually, your whole body affects the health of your knees. Any imbalance, like poor posture or a tense neck, can compound—or create—a knee injury. Your weight is distributed down your spine, through your sacrum and pelvis, and bears directly down on your knees. When you’re standing or sitting in an unnatural position, your knees will know it. The key to healthy knees, then, is to align your body in a balanced, natural state—a major tenet of yoga.
In order to visualize proper alignment, imagine dropping a plumb line down the center of your body. From the side, it should cross through the center of the ear, shoulder, hip, knee, and ankle. From the front, it should pass directly through the middle of your body, in between your lungs, through your pelvis, and down to the ground. This is the alignment of Tadasana (Mountain Pose). Once you find your optimal alignment in Tadasana and can carry that through other asanas, the energy flow of your practice will increase, which inherently promotes healing in your knees and throughout your body.
To maximize both healing power and leg strength, it’s important in each asana to concentrate on what Wallin calls “actively yielding” or finding the balance between strength and flexibility. Strength draws energy in, while flexibility sends it out and creates expansion in your body.
To find that point, Wallin shares advice she got from her teacher, John Friend, to hug your muscles to your bones on all four sides.
“When you do that, you engage your muscles enough to create sufficient stability in your body,” she explains. “Your nervous system will receive a signal that all is safe and it can draw energy and heal.”
Within that stable framework, you need to work within the range of functional flexibility, meaning you should be able to actively resist the position you’re in. Active resistance means your muscles are purposely engaged while you stretch. For example, in Trikonasana (Triangle Pose), you want your hamstrings on the side you bend towards to lengthen, but to also remain firm and lifted. Hanging into the pose can be especially bad for the knee, and if the hamstrings are not doing their part, the knee is likely to hyperextend.
If you go beyond a point where you can engage your muscles while you stretch—if you push yourself down into the splits, but have no control while you’re in them—your flexibility isn’t growing in an effective, safe manner. According to Tom McCook of The Center of Balance in Mountain Valley, California, then “you’re out of your range and are setting yourself up for an injury.”
If you concentrate on your whole body, you’ll be able to bypass your natural tendency to favor an injured knee. “When I was dancing, I had a hip injury,” remembers Wallin. “One day, I was standing at the bar and my teacher came over to me and said, ‘I can see your brain in your hip. Get your brain into your whole body.’”
If you’re delicately tiptoeing around a bum knee, you’re neglecting the rest of your body—and asking for more injuries. Instead, take it slowly and get reacquainted with your body and your practice. “An injury forces us to move back into our yoga practice with a beginner’s mind,” says Wallin. “We can let go of expectations and move within the boundaries of our body’s cur while doing Ashtanga Yoga. “The instructor adjusted me too hard,” he remembers. “I wasn’t aware enough to know the kind of pain I was going through was the wrong kind.”
The most natural—and safest—position is when your knee is aligned with your foot (if your foot is facing forward, so is your knee; if it’s sideways, your knee is too). Anything that causes searing pain should be stopped immediately. If need be, modify your position so that you’re comfortable.
For instance, when sitting in Baddha Konasana (Bound Angle Pose) with the soles of your feet together, you may need to move them away from you. Or you may need to use blankets in asanas like Virasana (Hero Pose), which puts pressure on the knees.
Asanas that tend to disrupt safe knee alignment—such as Padmasana (Lotus Pose), which calls for generous hip rotation—may aggravate an existing knee condition. Also, be extremely careful not to hyperextend (or push your knee back beyond straight) in asanas like Trikonasana (Triangle Pose).
Certainly caution is required in the initial stages of healing after a knee injury, but with time and attention, regular yoga practice can balance your body and turn your knees from one of the more delicate structures in your body to one of the most reliable-almost as reliable as a clutch jump shot.